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Podcast on ABC Radio – My interview about bipolar


Anne in ABC Studio

http://www.abc.net.au/overnights/stories/s3754799.htm

I have had my first radio interview. It was on ABC national radio on May 4th with Jen Fleming. I was nervous, but didn’t stress too much as it was going to be aired at 4.00am. Who listens to the radio at that time? Apparently many do and quite a few people I know told me they heard it. Others bought books because of it which is exciting. Apparently the interview had such a big response that they made a podcast.

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Art From Adversity book trailer


Here is the book trailer for my book.

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I’ll stand by you


Sometimes it is really hard to stand by someone who has a mental illness. You want to help them, and you do help them. Time and time again. Again and again. You forgive them. Again and again. But how many times do you stand by them as they make one bad decision after another, expecting that someone will always be there to pick up the pieces?

Someone very close to me has bipolar disorder. I haven’t spoken to him since his Armenian mafia phone call to me in the middle of the night. I can’t talk to him at the moment. His mental health is too precarious and I think my book has the potential to tip him over the edge. When I am next talking to him, I will tell him this, ‘I will stand by you, I will always love and support you, but I have limits and there are boundaries. Don’t call me at 1.30 am again telling me that you should be in a psych ward, call the Mental Health Crisis Team. Don’t ask for my advice if you are not going to do anything about is. I really hope that the Armenian mafia don’t get you. I can’t always help you, but one thing is certain – it might be hard, but I’ll always stand by you.’

Have you got a brother like this? Or a husband? Or a child? It’s easy to say ‘I’ll stand by you’, but not so easy to do.

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Life with bipolar is hard


I have just read an article written by Julie Fast in her BipolarHappens.com newsletter. She talks about how hard it is to have bipolar disorder and she says that, even though we can be positive, life is not easy. Anyone who has bipolar knows this.

I have a family and I am (mostly) able to function, even though my priorities are no longer to be Martha Stewart and Nigella Lawson. I am (mostly) able to cope with my two day a week job, but sometimes getting there is a challenge. I smile at the people I work with and the few I tell are genuinely shocked when I say I have bipolar disorder.

I don’t look sick and I do not want to see myself as a ‘sick’ person but bipolar affects me in big and small ways, and is with me every day. As Julie says, ‘It’s really hard’ and we need to be more honest about it.

Everyone has their own reality of bipolar disorder, and carers do as well. I do not want to identify myself primarily as a person with a mental illness, even though it is undeniable that I have one and that I and advocate for people who do. I am a writer, artist, teacher, wife, mother and friend who has bipolar, not a bipolar person who is a writer,artist etc. It is not just the rhetoric of political correctness to refer to myself this way. The distinction is really important to me.

I have  my own story and so does every other person with bipolar disorder. We need to tell our stories. That’s why I wrote my book.  To tell my story. My truth about bipolar.

Julie Fast is a real inspiration. Check her out.

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Anxiety


By M. Katherine Shear, M.D., Associate Professor of Psychiatry, University of Pittsburgh, Director, Anxiety Disorders Clinic.

”Anxiety is a normal part of everyday life. It acts as a signal which motivates us to improve performance and alerts us to impending dangers. Yet anxiety can get out of hand. When this happens, the normal warning signal mechanism of anxiety becomes a psychiatric symptom.

Anxiety symptoms occur in a group of disorders characterized by “free-floating” anxiety (panic disorder and generalized anxiety disorder), phobic anxiety (specific and social phobia), traumatic anxiety (posttraumatic stress disorder and acute stress disorder) and obsessive compulsive symptoms. Each of these disorders includes features of symptomatic anxiety, such as high levels of bodily arousal, excessive worries about potential danger, and avoidance of feared situations.

The disorders differ in the degree of preoccupation with body symptoms, the focus of worry and the extent and type of avoidance. Many clinicians and most consumers and their families are unfamiliar with the differences between these diagnoses and tend to view anxiety as a general and overall symptom. This is particularly true when an anxiety disorder occurs along with another illness, and when the latter illness is the focus of treatment. Nevertheless, the different anxiety disorders have different ways of working in the body and also have different responses to different kinds of treatment.

Anxiety disorders are the most common psychiatric conditions in the community. These disorders are often trivialized, in part because of their high frequency and in part because anxiety is a normal part of life. However, anxiety can become debilitating. Anxiety disorders have been shown to cause difficulty in people’ s ability to function in their daily lives and can affect quality of life as well. Experiencing a major depression greatly increases the likelihood of having an anxiety disorder. When an anxiety disorder is also present, depression is more severe and is more likely to fail to respond to treatment. The presence of panic attacks increases substantially the risk of suicide in a depressed individual. Other debilitating anxiety disorders, including social phobia, obsessive compulsive disorder, and post-traumatic stress disorder, are also commonly seen with depression.

Anxiety disorders appear to be common in people with bipolar disorder as well, yet anxiety is rarely discussed in the medical literature on bipolar illness. Clinicians and people with bipolar disorder may well be unaware of the potential very negative consequences of this seemingly unimportant complication.”

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Genetic basis of bipolar disorder


Oct. 10, 2012

Scientists from the Florida campus of The Scripps Research Institute (TSRI) have identified small variations in a number of genes that are closely linked to an increased risk of bipolar disorder, a mental illness that affects nearly six million Americans, according to the National Institute of Mental Health.

“Using samples from some 3,400 individuals, we identified several new variants in genes closely associated with bipolar disorder,” said Scripps Florida Professor Ron Davis, who led the new study, which was published recently by the journal Translational Psychiatry.

A strong tendency towards bipolar disorder runs in families; children with a parent or sibling who has bipolar disorder are four to six times more likely to develop the illness, according to the National Institute of Mental Health.

While the genetic basis for bipolar disorder is complex and involves multiple genes, it appears to be associated with a biochemical pathway known as cyclic adenosine monophosphate (cAMP) signaling system. The Davis laboratory and others have previously shown that the cAMP signaling plays a critical role in learning and memory processes. The new study focused on this signaling pathway.

“As far as I know, this has not been done before — to query a single signaling pathway,” said Davis. “This is a new approach. The idea is if there are variants in one gene in the pathway that are associated with bipolar disorder, it makes sense there would be variants in other genes of the same signaling pathway also associated with the disorder.”

The new study examined variations in 29 genes found in the two common types of bipolar disorder — bipolar disorder I (the most common form and the most severe) and bipolar disorder II. Genes from a total of 1,172 individuals with bipolar disorder I; 516 individuals with bipolar disorder II; and 1,728 controls were analyzed.

Several statistically significant associations were noted between bipolar disorder I and variants in the PDE10A gene. Associations were also found between bipolar disorder II and variants in the DISC1 and GNAS genes.

Davis noted that the location of PDE10A gene expression in the striatum, the part of the brain associated with learning and memory, decision making and motivation, makes it especially interesting as a therapeutic target.

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Bipolar disorder and disability


Higher education reduces the risk of becoming disabled. But this does not apply to everyone. Doctor Helle Schøyen has researched the connection between bipolar disorder and disability.

Bipolar lidelse
Helle Schøyen believes that early and effective treatment can help prevent recurring bouts of depression. Schøyen has carried out research on the connection between bipolar disorder and disability. Foto: Colourbox
 BY ELIN STENSVAND

Research has shown that the well-educated are less likely to become disabled. But when working on her doctorate, Helle Schøyen discovered that this did not apply to sufferers of bipolar disorders.
‘This relationship does not exist where bipolar disorder is concerned. We have however noticed that persons with bipolar disorder are often single and disabled, and earn less than other comparable groups. This is in spite of the fact that they have the same level of education as the normal population in the area’, says Schøyen.
Bipolar disorder includes what was previously known as manic-depressive disorder. Science defines it as ‘a mental disorder characterised by recurring episodes of mania and depression.’ One needs to have had at least one manic or hypomanic episode in order to be diagnosed with the disorder.

Intelligence and education

Education is not the only factor that has helped prevent disability amongst the general population. Intelligence also appears to provide protection. Schøyen looked at IQ and the functional level of people with bipolar disorder, both before and after the illness began to leave its mark.
‘We were surprised to discover that among bipolar sufferers, neither intelligence nor degree of function affects whether one becomes disabled’, she says.

Apparently well-functioning

Helle Schøyen is a psychiatric specialist and she has worked at the Psychiatric Clinic at Haugesund Hospital and Stavanger University Hospital. For her, this seemed the obvious approach to researching bipolar disorders.
‘I meet many people that have bipolar disorders through my work. They are usually well-educated people who are apparently well-functioning individuals. They are however, eventually affected by the illness. Many have great difficulty functioning at work, in the family and in other situations’, according to Schøyen.
To determine whether the severity of the bipolar disorder affected the risk of becoming disabled, she compared those who were treated as outpatients with those who were hospitalized. It turned out that there was no difference between the two groups. ‘It would appear that the risk of becoming disabled doesn’t depend on the severity of the bipolar disorder’.

Is education an easier option than work?          

Many bipolar sufferers work fulltime throughout their lives, whilst others are incapable of working. But is it possible to reverse the situation for those who have become disabled?
‘This was not a theme in my thesis, but I know that a survey is being carried out. My results indicate that work is affected regardless of how well educated one is. This could tell us if it’s part of the disease process, or if it’s “easier” being educated than it is to be at work’, explains Schøyen.
She thinks that the time aspect could also play a role. As the illness is recurrent, it can make working difficult. Being regularly depressed and having a long-term illness, often leads to disability, according to statistics.
‘It is a little surprising to discover that women are less at risk of becoming disabled than men’, she adds.

Early detection is important                                                                  

Schøyen’s study underlines the importance of early detection.
Providing early and effective treatment can help to prevent recurring bouts of depression. These appear to have a particularly detrimental effect on the bipolar patient’s ability to function. By trying to prevent recurrent relapses, one can perhaps prevent a decline in the social and occupational functions of bipolar patients.
Schøyen has based her thesis on patients who are part of ‘The Bipolar Research and Innovation Network study’ (BRAIN) and Thematic Area of Psychosis (TOP). They have been compared with a control group from the general public, supplied by Statistics Norway.

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Experimental drug may help people with bipolar disorder


I love this, a new drug that works like Lithium, without Lithium’s side effects of weight gain, thirst and kidney damage. Too bad that twice the correct dose will kill you. Not much margin for error.

Newspaper article on experimental drug for bipolar disorder

By Kate Kelland
LONDON | Tue Jan 8, 2013 11:31am EST

(Reuters) – A drug for bipolar disorder that works like lithium – the most common and effective treatment – but without lithium’s side-effects has been identified by British researchers in tests on mice. Scientists say the drug, ebselen, may be a swift answer to long-sought after better medications for patients with the manic depressive disorder, since it is already known to be safe. If the drug could be “repurposed” and licensed for the treatment of bipolar disorder, it could reduce the unpleasant side effects of weight gain, thirst and potential kidney damage that patients risk when taking lithium. “Ebselen is an experimental drug that has been tested in people for other conditions, and does not have problematic side effects like lithium does,” said Grant Churchill of the department of pharmacology at Britain’s Oxford University.

Bipolar disorder effects around 1 percent of the population worldwide and sufferers can experience moods that swing from one extreme to another, and have periods of depression and mania lasting several weeks or longer. These high and low phases are often so extreme they interfere with everyday life and work. In a telephone interview Churchill said that in tests, his team found that mice who were made manic with small doses of amphetamines were able to be calmed again with ebselen. “In mice, ebselen works like lithium,” Churchill said. “Now we urgently need to see if it works like lithium in people.” Some 60 years after it was first discovered, lithium – a mood stabilizer that can protect against both depression and mania, and reduce the risk of suicide – remains the most effective long-term treatment. But it is very toxic – at only twice the right dose it could kill a patient, Churchill said – and its adverse side-effects mean many people stop taking the drug and relapse into episodes of mania and depression.

Churchill worked with Sridhar Vasudevan to filter through a library of existing drugs – the U.S. National Institutes of Health Clinical Collection – that are considered safe but do not currently have a proven use. They screened the library for any drugs that blocked an enzyme that is key to lithium’s success and found ebselen was a possible lithium mimic. “This is one of the first handful of examples of drug repurposing, where a new use has been found for an existing drug,” Vasudevan said. Ebselen is an antioxidant originally developed up to late stage, or phase III, clinical trials by the Japanese firm Daiichi Sankyo for the treatment of stroke, but which never reached market and is now out of patent. Vasudevan said his study, reported in the journal Nature Communications, showed ebselen had the same or similar action as lithium in the brains of mice, blocking the same enzyme. The researchers are a now starting a small study in healthy human volunteers to look for effects on brain function. If that shows ebselen has similar effects to lithium, they plan to move to second stage trial in bipolar patients.

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Children of bipolar parents score higher on creativity test, Stanford study finds


Researchers at the Stanford University School of Medicine have shown for the first time that a sample of children who either have or are at high risk for bipolar disorder score higher on a creativity index than healthy children. The findings add to existing evidence that a link exists between mood disorders and creativity.

The small study, published in the November issue of the Journal of Psychiatric Research, compared creativity test scores of children of healthy parents with the scores of children of bipolar parents. Children with the bipolar parents—even those who were not bipolar themselves—scored higher than the healthy children.

“I think it’s fascinating,” said Kiki Chang, MD, assistant professor of psychiatry and behavioral sciences and co-author of the paper“There is a reason that many people who have bipolar disorder become very successful, and these findings address the positive aspects of having this illness.”

Many scientists believe that a relationship exists between creativity and bipolar disorder, which was formerly called manic-depressive illness and is marked by dramatic shifts in a person’s mood, energy and ability to function. Numerous studies have examined this link; several have shown that artists and writers may have two to three times more incidences of psychosis, mood disorders or suicide when compared with people in less creative professions.

Terence Ketter, MD, professor of psychiatry and behavioral sciences and a study co-author, said he became interested in the link between mental illness and creativity after noticing that patients who came through the bipolar clinic, despite having problems, were extraordinarily bright, motivated people who “tended to lead interesting lives.” He began a scholarly pursuit of this link and in 2002 published a study that showed healthy artists were more similar in personality to individuals with bipolar disorder (the majority of whom were on medication) than to healthy people in the general population.

Some researchers believe that bipolar disorder or mania, a defining symptom of the disease, causes creative activity. Ketter said he believes that bipolar patients’ creativity stems from their mobilizing energy that results from negative emotion to initiate some sort of solution to their problems. “In this case, discontent is the mother of invention,” he said.

The researchers point out that creativity and bipolar may have important genetic components that are transmitted together inter-generationally. There have only been limited studies investigating this; the Stanford study is the first to specifically examine creativity in the offspring of bipolar parents.

During the study, the researchers looked at creative characteristics in 40 bipolar patients and 40 offspring, comparing them with 18 healthy adults and 18 healthy offspring. The children in the study ranged in age from 10 to 18. Half of the children of bipolar patients also had bipolar disorder; the other half had attention deficit hyperactivity disorder or ADHD, which appears to be an early sign of bipolar disorder in offspring of parents with the condition. The majority of participants with bipolar or ADHD were on medication.

The researchers included children with ADHD so they could study creativity before the onset of full bipolar disorder. “We wanted to see whether having a manic episode is necessary for this sort of creativity,” said Chang, who also directs the Pediatric Bipolar Disorders Program at Lucile Packard Children’s Hospital.

Study participants were given psychiatric evaluations and then completed the Barron-Welsh Art Scale, or BWAS, a test that seeks to provide an objective measure of creativity. The scoring is based on “like” and “dislike” responses to figures of varying complexity and symmetry; past studies suggest that creative people tend to dislike the simple and symmetric symbols.

The researchers found that the bipolar parents had 120 percent higher BWAS “dislike” scores than the healthy parents. The children with bipolar and the children with ADHD had, respectively, 107 and 91 percent higher BWAS dislike scores than the healthy children.

“The results of this study support an association between bipolar disease and creativity and contribute to a better understanding of possible mechanisms of transmission of creativity in families with genetic susceptibility for bipolar disease,” the researchers wrote in their paper.

The researchers had hypothesized that the scores of children with ADHD would differ significantly from the scores of bipolar children so they were surprised when the scores did not. Chang said this indicates that mania is not what is fueling the creativity. “The kids with ADHD who hadn’t been manic yet still had very high levels of creativity,” he said.

The researchers also found a link between the length of a bipolar child’s illness and creativity: the longer a child was sick or manic, the lower the BWAS dislike score. It makes sense, Chang said, that this illness could, over time, erode one’s creativity. “After awhile you aren’t able to function and you can’t access your creativity,” he explained.

BWAS dislike scores tend to decrease with age even in healthy individuals, so more research is needed, Ketter said. Further studies are also needed to assess the role of genetic and environmental factors in creativity and bipolar, he added. The team plans to next examine whether the degree of creativity in parents correlates with the degree of creativity in their children.

This study was funded by the Heinz C. Prechter Fund for Manic Depression, a NAR-SAD Young Investigators Award, a Klingenstein Third Generation Foundation Fellowship and the National Institutes of Health.

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Don’t look back in anger


Slip inside the eye of your mind
Don’t you know you might find
A better place to play
You said that you’d never been
All the things that you’ve seen
Will slowly fade away

So I start the revolution from my bed
‘Cos you said the brains I have went to my head
Step outside the summertime’s in bloom
Stand up beside the fireplace
Take that look from off your face
You ain’t ever gonna burn my heart out

So Sally can wait, she knows its too late as we’re walking on by
Her soul slides away, but don’t look back in anger I hear you say

Take me to the place where you go
Where nobody knows if it’s night or day
Please don’t put your life in the hands
Of a Rock n Roll band
Who’ll throw it all away

Got I start the revolution from my bed
‘Couse you said the brains I have went to my head
Step outside ‘couse summertime’s in bloom
Stand up beside the fireplace
Take that look from off your face
‘Couse you ain’t ever gonna burn my heart out

So Sally can wait, she knows its too late as she’s walking on by
My soul slides away, but don’t look back in anger I hear you say

Don’t look back in anger
Don’t look back in anger
Don’t look back in anger
At least not today

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